Invasive stratified mucin-producing carcinoma(ISMC)is a recently described histologic variant of high-risk human papillomavirus(HPV)-associated endocervical adenocarcinoma,as the putative invasive counterpart of the s...Invasive stratified mucin-producing carcinoma(ISMC)is a recently described histologic variant of high-risk human papillomavirus(HPV)-associated endocervical adenocarcinoma,as the putative invasive counterpart of the stratified mucin-producing intraepithelial lesion(SMILE).ISMC can display variable architectural patterns and usually coexists with other more conventional types of HPV-associated carcinomas,which makes diagnosis and differential diagnosis of ISMC is difficult for pathologists.Moreover,the prognosis of ISMC is still controversial.We analyzed 6 ISMCs with detailed pathological and clinical information.Intraepithelial lesion,including 1 high-grade squamous intraepithelial lesion and 1 SMILE,was found.Various architectures were observed(including nest,glandular,solid,trabecular,and single cell).Nuclear peripheral palisading,apoptotic bodies and mitoses,and variable cytoplasmic mucin vacuoles were seen in all of our cases.The predominance of neutrophils infiltration was seen in only 1 tumor.All the tumors infiltrated the cervical stroma in Silva pattern C manner.p63 and/or p40 was characteristically expressed in the peripheral cells in only 2 cases.High-risk HPV infection was observed in 3/3 detected cases.All the patients were alive during the follow-up time.Recognition of this infrequent tumor may help pathologists and oncologists for an accurate diagnosis and a better understanding of the clinicopathological behavior.展开更多
目的:探讨宫颈原位腺癌(adenocarcinoma in situ,AIS)的临床病理特征和诊断要点。方法:回顾性分析某医院病理科存档的10例宫颈原位腺癌患者的临床及病理资料,并复习相关文献。结果:年龄31~51岁,平均年龄44岁。7例表现为腰痛、异常的阴...目的:探讨宫颈原位腺癌(adenocarcinoma in situ,AIS)的临床病理特征和诊断要点。方法:回顾性分析某医院病理科存档的10例宫颈原位腺癌患者的临床及病理资料,并复习相关文献。结果:年龄31~51岁,平均年龄44岁。7例表现为腰痛、异常的阴道流血及排液,3例无明显的临床症状,因HPV检测阳性而行宫颈活检确诊。9例为宫颈内膜型,1例为复层产黏液性上皮内病变(SMILE);5例为单纯宫颈原位腺癌,5例伴有高级别鳞状上皮内病变(HSIL)。镜下观察,单纯性AIS腺体仍保持原有的结构特征,但细胞异型性明显,细胞核拥挤、深染、重叠,核分裂象多见,可见凋亡小体。SMILE肿瘤细胞由复层上皮细胞构成,可见富含黏液细胞或具有产黏液趋势,巢团状排列。10例细胞不同程度阳性表达p16、CEA,Ki67增殖指数均>20%;术后1例进展为浸润性腺癌,2例失访,余均无病生存。结论:宫颈原位腺癌缺乏典型的临床表现且病变位置较深,具有相对特异的形态学改变和免疫表型,需要充分的病理取材和临床密切随访。展开更多
基金the Scientific Research Funds Project of the Science and Technology Department of Sichuan Province(Grant No.21YYJC1616 to Liu Y).
文摘Invasive stratified mucin-producing carcinoma(ISMC)is a recently described histologic variant of high-risk human papillomavirus(HPV)-associated endocervical adenocarcinoma,as the putative invasive counterpart of the stratified mucin-producing intraepithelial lesion(SMILE).ISMC can display variable architectural patterns and usually coexists with other more conventional types of HPV-associated carcinomas,which makes diagnosis and differential diagnosis of ISMC is difficult for pathologists.Moreover,the prognosis of ISMC is still controversial.We analyzed 6 ISMCs with detailed pathological and clinical information.Intraepithelial lesion,including 1 high-grade squamous intraepithelial lesion and 1 SMILE,was found.Various architectures were observed(including nest,glandular,solid,trabecular,and single cell).Nuclear peripheral palisading,apoptotic bodies and mitoses,and variable cytoplasmic mucin vacuoles were seen in all of our cases.The predominance of neutrophils infiltration was seen in only 1 tumor.All the tumors infiltrated the cervical stroma in Silva pattern C manner.p63 and/or p40 was characteristically expressed in the peripheral cells in only 2 cases.High-risk HPV infection was observed in 3/3 detected cases.All the patients were alive during the follow-up time.Recognition of this infrequent tumor may help pathologists and oncologists for an accurate diagnosis and a better understanding of the clinicopathological behavior.
文摘目的:探讨宫颈原位腺癌(adenocarcinoma in situ,AIS)的临床病理特征和诊断要点。方法:回顾性分析某医院病理科存档的10例宫颈原位腺癌患者的临床及病理资料,并复习相关文献。结果:年龄31~51岁,平均年龄44岁。7例表现为腰痛、异常的阴道流血及排液,3例无明显的临床症状,因HPV检测阳性而行宫颈活检确诊。9例为宫颈内膜型,1例为复层产黏液性上皮内病变(SMILE);5例为单纯宫颈原位腺癌,5例伴有高级别鳞状上皮内病变(HSIL)。镜下观察,单纯性AIS腺体仍保持原有的结构特征,但细胞异型性明显,细胞核拥挤、深染、重叠,核分裂象多见,可见凋亡小体。SMILE肿瘤细胞由复层上皮细胞构成,可见富含黏液细胞或具有产黏液趋势,巢团状排列。10例细胞不同程度阳性表达p16、CEA,Ki67增殖指数均>20%;术后1例进展为浸润性腺癌,2例失访,余均无病生存。结论:宫颈原位腺癌缺乏典型的临床表现且病变位置较深,具有相对特异的形态学改变和免疫表型,需要充分的病理取材和临床密切随访。
